Hadadi A, Moradmand Badie S, Roham M, Rasulinejad M, Mirzai N,
Volume 67, Issue 8 (6 2009)
Abstract
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Background: One of the clinical manifestations of Human Immunodeficiency Virus (HIV)
infected patients is cardiovascular disorder. The aim of this study was to
evaluate the prevalence of cardiovascular disorders in HIV
infected patients for the beginning treatment of these patients and reducing
mortality and morbidity in these patients.
Methods: This cross-sectional study was performed on 134 HIV
infected patients who referred to Imam Khomeini hospital, Tehran University of
Medical sciences, Tehran Iran during years 2007-2008.
Demographic characteristics, history of smoking and opium addiction,
antiretroviral therapy, class of drugs and duration of consumption were
recorded. After completion of physical examination, electrocardiography and
echocardiography studies were done.
Results: In this study 98(73.1%) patients were male.
The mean age of the patients was 36.5±10.3
years. The mean of the CD4 number were 296±181. Injection drug users were 54.4%
of the study patients. Cardiovascular disorders were found in 84(62.7%)
patients. Among patients with heart diseases, 75%
were male. The most Electrocardiographic change was the axis deviation of the
heart found in 32(23.7%) patients.
Pericardial effusion and LVEF<50% were
noted in 7(5.2%) and 23(17.2%)
patients respectively. The involvement of the mitral valve
in 59(44%), tricuspid valve in 21(15.7%)
and aortic valve in 6(4.5%) patients were
noted. Myocardial dysfunctions existed in 10(7.4%)
patients.
Conclusions: Our results showed a high prevalence of cardiovascular disorder in HIV
infected patients. We recommend the evaluation of the cardiovascular
system in all HIV infected patients
even if they are symptom free.
Naser Gharebaghi , Mohammadamin Valizade Hasanloei, Seied Hasan Adeli , Seied Arash Mansuri Zangir , Javad Rasuli ,
Volume 71, Issue 10 (January 2014)
Abstract
Background: Stress Ulcer Prophylaxis (SUP) is important in patients in Intensive Care Units (ICU). In this study, we evaluated the efficacy of the American Society of Health System Pharmacists (ASHP) guidelines, for stress ulcer prophylaxis.
Methods: In this Quasi experimental study, data of patients that admitted to the ICU of Imam Khomeini Hospital of Urmia was recorded for three months. Then our guideline that was selected on the basis of ASHP guidelines were presented to physicians for one month and then patients’ data were collected again. The patients that hospitalized due to acute gastrointestinal bleeding and died in the early hours of admission were excluded. The data were analyzed.
Results: This study involved 234 patients, of them 112 patients (91.1%) in the pre- intervention period and 99 patients (89.2%) in the post-intervention period had received acid-suppressive therapy (AST) (P=0.632). Of 77 patients (62.8%) in the pre- intervention period and 88 (79.3%) in the post-intervention period had an indication for SUP according to our ASHP-based guideline (P=0.005). Of the patients without an indication for SUP, 39 of 123 (31.7%) received AST in the pre-intervention period versus 18 of 111 (16.2%) in the post-intervention period (P=0.006). of 112 (91.1%) cases in the pre-intervention period compared with 93 (83.8%) cases of the prescription drug order was incorrect (P=0.092). Gastrointestinal bleeding were in five patients (4.1%) found during the pre-intervention period and 8 (7.2%) cases in the post-intervention period (P=0.295).
Conclusion: In this study the majority of cases not been in accordance with the ASHP-based guideline and our education did not affect the quality of stress ulcer prophylaxis. It seems that more attention to the training of physician in the prophylaxis of stress ulcer can be effective in improving the health status of patients and additional costs may be reduced.
